A study from the University of Washington shown patients with spinal cord injury (SCI) may complain of upper extremity (UE) pain. The study questioned 130 participants and reported 58.5% reported some form of pain, 71% complained of shoulder pain, 53% had wrist pain, 43% experienced hand pain while 35% had elbow pain. Upper extremity pain was more likely to be experienced with function activities, such as pressure relievers, transfers, and wheelchair mobility. This is a common problem in individuals with SCI and has an impact on daily activities. There needs to be prevention and management programs for SCI patients. Physical therapy is a good place to start and the most popular option for SCI patients suffering from upper extremity pain.
5 Common Types of Upper Extremity Pain and How to Treat Them
1. Hand pain: SCI patients often complain of hand pain, occurring initially at night. Weakness and atrophy can occasionally occur, leading to loss of grip strength. Hand dynamometers can be used to reliably measure and document muscle strength for SCI patients and their response to treatment.
2. Bicipital Tendinitis: Patients with bicipital tendinitis complain of pain over the front of the shoulder which can radiate down the arm, towards the deltoid or to the base of the neck. Using rest, medication and ice to manage the pain in the acute phase, gentle stretching along with heat and ice can be used once the acute phase of the injury has passed.
3. Tennis Elbow: Patients with SCI may experience another repetitive use injury, Tennis Elbow, because of the forceful elbow extension, maximum pronation, and wrist flexion needed to use a wheelchair. Electrical Stimulation can be useful in the treatment of Tennis Elbow for SCI patients by making the muscle contract which can help decrease muscle spasm.
4. Carpal Tunnel: The repetitive stress of using a wheelchair also predisposes the wrists of patients with a number of overuse tendinitis issues, specifically carpal tunnel. Heating modalities such as paraffin wax baths can help decrease pain and increase the range of motion of the wrist.
5. Shoulder Pain: The main reason an increase in shoulder pain in SCI patients is this population relations entirely on the upper limb for both ambulation and weight-bearing tasks. The shoulder is not designed for this type of reliance. Using Cold Compression Therapy wraps for the shoulder will help decrease inflammation and pain experienced in the shoulder, specifically in the rotator cuff.
The necessary reliance on the upper extremities place spinal cord injury patients at a higher risk for upper extremity pain. This pain, if left untreated, can hinder daily activities. Pain management programs must be created and implemented for SCI patients to be able to flourish.